Wednesday, July 30, 2008

bullets here and here

‘You motherfucking scum. You think you treat me like this? Like I don’t care, don’t mind? Like I’m a nothing man? You motherfucking piece of trash. I kill you. I smash you. I piss on you. You bring me here and expect me wait in there? With that people? Five, six hours? No. No, no, no. This not right. You see me now. You see me and you fix me up or I kill you.’He pulls up his t-shirt and smacks his lean belly. We stand there, turned sideways so we’re less of a target, arms at our sides, watching him, waiting for security. Where are security?‘See this? See this, you motherfucking scum? You think I don’t know what pain is? You think I care what you do? I got bullets here, bullets here. Here. I got half a head – boom. You think I care what you think you do to me? You motherfucking scum. You see me now. I see the doctors now. Come. Take me to the doctors.’The charge nurse says: ‘I’m not taking any more of this crap.’ But all he seems able to do is hit the redial button. Everyone and everything in the immediate vicinity has slowed or stopped, dragged into the tow of this curious man’s rage. We’re all waiting for him to do something, to hit someone, or try to. He raises his crutch, then lowers it again.‘Hrrrrrr’ he says. Hobbles off, then comes straight back.‘You think I care what you do to me?’‘Listen, Gil. We’re here to help you. We’ve brought you to hospital because you said you wanted to see a doctor about your hip. You will get to see a doctor, but there is a wait, unfortunately. All these people are in the same boat.’I risk a glance past Gil’s shoulder into the waiting room. I catch the eye of a woman and her teenage daughter, the daughter clutching her arm, both of them staring across from the hard blue seat of their ordeal. ‘Just look around you, Gil.’But he merely carries on fronting us out, waving his crutch occasionally like an enraged gorilla thrashing a branch. Eventually he turns and crashes an exit through the crowded waiting room, off into the car park. Two minutes later security arrives.‘He’s about five foot six, wearing a cap with a red star on the front, using one crutch…’ I tell them.‘Yes, yes, we saw it all on the cameras.’They stroll cautiously outside to see if he’s still around.‘They saw it on the cameras,’ says the charge nurse. ‘Great. We were never in any danger, then.’

When we had answered the red call to the man collapsed in the street, we’d found Gil and another man standing arguing on the pavement. Gil had a bloody cut to his eyebrow – his friend roughed in the details through a bad-tempered storm of interruptions: Gil had been sitting against a wall, had tried to stand up, lost his footing and grazed his head. He hadn’t lost consciousness, hadn’t felt unwell, and as far as he knew that was the only thing wrong with him. ‘Gil – we need to get you on the vehicle, clean you up and see what’s happened. But Gil – we also need you to calm down, okay? We’re here to help you. Can you do that for us? Just slow down, take it easy and we’ll see what’s what.’Amazingly this seems to work. He slumps into himself, but steps nimbly enough up onto the ambulance.

In the good interior light we get a clear view of our patient. The most immediately striking thing about him is his head. He has a palm sized depression on the right side of his skull, yellowed and sunken below the cropped lines of his scalp. It looks like an old plastic plug that’s dried and receded. Its edges are ragged, suture like. ‘How did you get that?’ I ask him. ‘Ach. You don’t know and you don’t want to know. I got bullet here, here. I got explosion from mine. My hip, my head, my liver, my god - everything. Iraq. Afghanistan. Israel. Pow.’‘So you were a soldier, Gil?’He pulls up the sleeve of his jacket. ‘Look here. Bullet, bullet. Here also. Ach.’We tour his scars, awful knots of pale knitted flesh rucked and raked together on his arms, his abdomen, his legs. Whether this was all the result of one explosion or a collection of wounds, it’s impossible to determine. He’s had a few cans of lager, it’s late at night, and all he seems to want is to see someone about his hip.‘I had replacement,’ he says, smacking his right hip. ‘It hurts me now three four week. I need to see doctor.’I start to clean up the wound on his eyebrow, which doesn’t seem bad.‘So it’s not new pain tonight? And you’ve had it for a few weeks. Can I ask why you didn’t see a doctor before now?’Gil pushes my hand away, wipes his eye-line with the back of his hand, pulls his cap back on, pulls his crutch upright in front of him like a rifle. ‘You take me doctor now.’

When the ambulance pulls in to the A&E car park, Gil seems more relaxed. ‘I get out now?’ ‘Let’s just wait for Frank to finish reversing.’Frank opens up the back door. ‘Would you like a chair?’‘I walk. I not dead yet.’ I lead him into the minors area. He looks around him at the people scattered despondently around the purple waiting room.‘Take a seat, Gil, whilst I go and have a word with the nurse.’But he doesn’t sit down.‘What means this?’ he says. ‘Take a seat. I’m afraid there may be a little wait to see someone. They’re quite busy tonight.’I walk off towards the nurse’s station. Frank comes with me, rather than going off to make some coffee. He can sense the charge in the air. ‘No!’ shouts Gil. ‘You not do this to me. I not wait here. I see doctor now.’He hurries after us and nails us in front of the nurse’s desk. We are in danger, a marked target. I wonder – should he attack– whether anyone will break from the anonymous safety of the herd to come to our assistance.

Another excellent post...as usual ;) The way we treat our armed forces is a disgrace, but it doesn't seem to have occurred to anyone in govt or the media that this is not unusual behaviour for men who've been trained to do and see the most terrible things without the appropriate psychological support. As you describe it is a particular problem after they are injured, or get drunk and all that trauma comes flooding out. How often do you have to deal with this kind of situation these days?BG

Hi LivI know - there doesn't seem to be any shortage of unpleasant punters, certainly not round here. But still - I think the nice ones balance out the nasty ones. Just.

It's interesting to think about Gil's background. I guess he was a soldier at some point, but who knows where. I wonder if his head wound has led to some marked personality changes - that, plus the drink!Sx

Hi BG. We do see a fair bit of aggressive behaviour from guys on the street, drinking heavily, drugs too. I think a significant number are ex-army, but you don't always know. Gil was def ex military. His accent seemed either Sth African or maybe Israeli. He could've been a mercernary. He certainly looked mean enough! Sx

I had a patient the other night who I thought was going to kick off at me............ unfortunately I was in their house, on my own with him as he recovered from a seizure, my partner was outside the room asking relative about history........... People get certain aura, expression and body language and the atmosphere in the room changes...... never a good situation but unfortunately a regular one.